Active NPI
Lance Wayne Coleman, MD
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Meridian, ID
National Provider Identifier
1548204589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- M7160
- Practice address
- 520 S Eagle Rd
#1223
Meridian, ID 83642-6308 - Phone
- (208) 888-4368
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | M7160 | ID | Primary |
Addresses
Primary practice location
520 S Eagle Rd
#1223
Meridian, ID 83642-6308
Mailing address
520 S Eagle Rd
#1223
Meridian, ID 83642-6308
Phone (208) 888-4368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M7160 | ID | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193270400000",
"number": "1548204589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S EAGLE RD",
"address_2": "#1223",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426308",
"telephone_number": "208-888-4368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S EAGLE RD",
"address_2": "#1223",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426308",
"telephone_number": "208-888-4368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "LANCE",
"middle_name": "WAYNE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2007-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "ID",
"license": "M7160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.